In recent months, many miracles against COVID-19 have been announced. Vaccines that seem so, but no. And drugs that do not quite show their effectiveness.
The times of science they are not always as fast as we would like, despite the fact that medical research has stepped on the gas as never before in history. Solidarity, the large international trial led by the World Health Organization (WHO), has just released its first results six months after it began, eight months after the genome of a brand new virus.
His main conclusion: drug therapies remdesivir, hydroxychloroquine, lopinavir or ritonavir and interferon they have had little or no effect on mortality. The results still need to be reviewed by the scientific community, which has raised some doubts. But even so, Solidarity hides important lessons for science and for humanity.
With Trump it all started
On March 19, eight days after WHO declares the pandemic, the president of the United States, Donald Trump, launched a sign of optimism unfounded. It would be the first of many. The president assured that the FDA (the US drug agency) was ready to approve several treatments for COVID-19, including one with hydroxychloroquine, a long-used antimalarial medicine.
For the next two months, Trump continued to defend the use of the drug, getting to self-medicate, despite the fact that there was no evidence of its effectiveness. At the end of May, following the advice of his doctors and the experts around him, he decided to stop taking hydroxychloroquine. But the debate was on. Meanwhile, science was looking for answers to cling to.
What is Solidarity?
The search for effective drugs against a disease is a complex process full of tests and controls. After all, the objective is to end up giving the go-ahead to a substance that can end up consuming the entire population worldwide (and even more so, in a pandemic situation). It is difficult to think that there are pharmaceutical companies or health authorities who want to risk something going wrong.
Therefore, apart from the hundreds of other independent studies under way, the WHO decided to launch a large international trial now In March, when there were barely 200,000 infected with COVID-19 in the world. He christened it Solidarity and set himself the objective of adding the support of the largest number of hospitals and scientific institutions possible. I wanted to turn it into one of the largest international randomized trials about treatments against the new disease.
Half a year later, with about 56 million infected (and 1.3 million confirmed deaths), the trial has met one of its objectives. As of October 2, more than 12,000 patients from 500 hospitals from all over the world had participated in Solidarity. Furthermore, the trial is ongoing and a total of 116 countries have expressed interest in participating. But we are going with the first results.
Provisional and controversial conclusions
This first phase of Solidarity has analyzed the cases of 11,200 adult patients, from 32 different countries; patients who received treatments with any of the four substances under study. You have examined the effect of medications remdesivir, hydroxychloroquine, lopinavir / ritonavir, and interferon in overall mortality, initiation of ventilation, and length of hospital stay of the sick.
The provisional results, which for the moment are available in the form of preprint (an article that has not yet been peer-reviewed), conclude that the substances “appear to have little or no effect in mortality at 28 days or in the hospital evolution of COVID-19 patients ”, such as have pointed out from the WHO.
The urgency in presenting the results, before completing the usual processes of scientific review, has earned the WHO criticism. Above all, from the affected pharmaceutical companies. The public dissemination of preprints it has been common throughout the pandemic. With the encouragement of speed up investigation times, on many occasions it has ended up creating confusion.
The pharmaceutical company Gilead has been the one who has spoken the most against the publication of provisional data. “The preliminary results of the WHO seem inconsistent”, They assure from the company that develops remdesivir. In fact, other studies, such as the one recently published in the ‘New England Journal of Medicine’, point out that remdesivir does effectively shorten the hospital stay of those infected.
The positive lessons
While we wait review of early data from Solidarity, and beyond the necessary debate in the scientific community, the development of this study leaves positive lessons. On the one hand, the trial is ongoing and is studying the effects of other drugs in large and very different populations; something, generally, difficult to carry out. As an example, the study Gilead points out worked primarily with patients from the United States and a few from nine other countries.
On the other hand, the development, implementation and progress of Solidarity, with hundreds of medical and scientific institutions involved, in the midst of a pandemic, has shown a different way to act, effectively and quickly, against emerging diseases. For example, already in July, following the recommendations that came from the committee that manages the trial, the WHO recommended stopping hydroxychloroquine and lopinavir / ritonavir treatments worldwide, as they could have adverse effects.
Before the emergencies of the pandemic, learn to travel the path of research as fast as possible (without skipping the necessary steps) is key. Be it with medicines, vaccines or good practices to contain the infections, a few months or so can mean millions of lives.